Chapter 2: Views of the Affordable Care Act and Its Future

Public views of the 2010 health care law have changed little over the past several months. Currently, 55% disapprove of the Affordable Care Act and 41% approve. In September, before the launch of the online health care exchanges, 53% disapproved and 42% approved.

Republicans continue to be largely united in their opposition of the health care law — 88% disapprove and 10% approve of it. Among Democrats, about three-in-four (73%) approve, while roughly one-in-four (24%) disapprove of the law. Independents remain mostly opposed to the law, with 57% disapproving and about four-in-ten (39%) approving of it.

There continue to be substantial educational differences in views of the law. By 58% to 40%, those with a post-graduate degree approve of the Affordable Care Act. People with a college degree, but no graduate degree, are divided (48% approve, 50% disapprove) while those who have not completed college disapprove of the law by a wide margin (58% to 37%).

As in earlier surveys, opposition to the law is more intense than support: 43% of the public disapproves of the law very strongly and 11% disapprove of it not so strongly. By comparison, 26% approve of the law very strongly while 13% approve of it not so strongly.

Republicans and Republican leaners who agree with the Tea Party have a particularly negative assessment of the law. Almost all Tea Party Republicans (97%) disapprove of the law and about nine-in-ten (91%) disapprove very strongly. Among non-Tea Party Republicans, 83% disapprove and 67% disapprove very strongly.

Are the Health Care Law’s Major Provisions Here to Stay?

Nearly half of the public (49%) thinks the major provisions of the ACA are “probably here to stay,” while 43% believe the major provisions “will probably be eliminated.”

Most supporters of the law are confident that the major provisions are here to stay. Two-thirds of ACA approvers (67%) say this, compared with 27% who think the major provisions will probably be eliminated. Most opponents think that the major provisions will probably be eliminated, but the gap is smaller – 55% believe the provisions will probably be eliminated and 36% think they are probably here to stay.

College graduates are more likely than those with less education to predict that the major provisions are probably here to stay and this is the case among supporters and opponents of the law. Among those who approve of the law, 80% of college graduates believe its provisions are here to stay, compared with 60% of those without college degrees.

College graduates who disapprove of the law are divided in their outlook: 46% think the law’s major provisions are here to stay and 46% believe they will be eliminated. Most ACA opponents who do not have a college degree believe the major provisions will be eliminated (58%), while just 33% say they will remain in place.

Most Important Reasons Why People Oppose, Support Law

When asked about reasons why they disapprove of the law, large majorities of opponents cite too much government involvement in health care as a major reason (80%). Nearly as many (76%) cite their belief that the law is too expensive for the country.

Smaller majorities point to the individual requirement to get health insurance (58%) and the belief that their own health care may suffer (57%) as major reasons for opposing the law.

When asked the most important reason why they oppose the law, a 42% plurality say it is the over-involvement of the government in health care. About one-in-four (26%) say the most important reason is the law’s cost, while 14% cite the individual mandate and 12% say it’s because their own health care may suffer.

Among those who approve of the law, about equally large majorities say major reasons for their support are the expansion of health coverage to the uninsured (86%) and the guarantee of coverage for those with pre-existing conditions (84%). Other major reasons include the belief that the law will lower the country’s health care costs (68%) and that it will improve one’s own health care coverage (46%).

Most people who approve of the ACA cite either the expansion of coverage to the uninsured (39%) or the assurance of coverage for pre-existing conditions (35%) as the most important reason for their support. Fewer mention the lowering of the country’s health care costs (14%) or the improvement of one’s own health care coverage (6%) as the most important reason.

Confidence on Health Care Policy

When it comes to health care policy, the public expresses more confidence in Obama and Democratic leaders than Republican leaders in Congress to do the right thing. However, the differences have narrowed slightly since late last year.

On health care policy, 46% express a great deal or fair amount of confidence in Obama, 45% express at least a fair amount of confidence in Democratic leaders, while 37% have confidence in Republican leaders. This is a slight improvement for Republican leaders since December 2013, when 32% of the public had confidence in GOP leaders on health care policy (and 50% had confidence in Obama).

Today, more independents have confidence in Obama than Republican congressional leaders on health care policy (43%-34%). But independents’ confidence in Republican leaders in Congress on health care has risen 11 points since December, from 23%, while confidence in Obama is little changed.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts.